Lands of Opportunity: Diabetes in the Caribbean

A Case Study

Structure

Introduction• Historical Context:– MRC– Colonial Development– Chronic Conditions and Spread of Research

Interests

• Case Study – ERU and Diabetes• Conclusion – Postcolonial History of Medicine

Introduction

• Postcolonial Medicine usually approached from two different standpoints.

• Today - research & (post)metropoles included.

• Diabetes as medium for this inclusion.

• Case study of the ERU as empirical example.

Structure

• Introduction

Historical Context:- MRC- Colonial Development- Chronic Conditions and Spread of Research

Interests• Case Study – ERU and Diabetes• Conclusion – Postcolonial History of

Medicine

Great Britain – MRC est. 1913Great Britain – MRC est. 1913

The Medical Research Council – A Whirlwind History

1913 – Committee to Research TB.

1920s – Structures National Policy under Fletcher.

1940s – Enlarged budget, extra weight.

Constructive ColonialismGreat Britain CMRC 1945-

1962

Great Britain CMRC 1945-

1962

Jamaica – UWI, est. 1948

- TMRU est. 1956

Jamaica – UWI, est. 1948

- TMRU est. 1956

War-time nationalism and post-war welfarism

Fast-track to modernity to mutually beneficial independence

Research and Universities integral

Colonial University-Colleges, 1948-9

CMRC and MRC Membership Shared

Colonies places to expand interest

Changing British epidemiology & new technologies bring new conditions of interest

New interest reflected in colonial applications

Chronicity:Diabetes in the Colonies

Great Britain-MRC

&CMRC

Great Britain-MRC

&CMRC

Shaper, Application for Biochemical Studies, Uganda, 1959

‘despite the known susceptibility of diabetics in Europe and America to vascular disorders, these complications are significantly uncommon in Ugandan African diabetics. The biochemical background to the absence of these changes in our diabetics may well

prove of significance in the understanding of their development in Western communities.’

Uganda - Makerere University

College

Uganda - Makerere University

College

Structure

• Introduction• Historical Context:– MRC– Colonial Development– Chronic Conditions and Spread of Research

Interests

Case Study – ERU and Diabetes• Conclusion – Postcolonial History of Medicine

Epidemiological Research Unit, Jamaica

Plan for ERU orginated in Britain.

Chronic disease epidemiology growing influence in the 1950s.

Cochrane and Miall – Welsh studies.

Comparisons in LDCs – Jamaica.

Jamaica - Pilot

Studies, 1958- ERU est.

1962

Jamaica - Pilot

Studies, 1958- ERU est.

1962

Cardiff – ERU, Wales, 1960

Cardiff – ERU, Wales, 1960

W.E. Miall, Application for Unit in Jamaica, 1959

‘The results achieved during the first year of epidemiological work in Jamaica are so encouraging that we believe steps should be taken to exploit the opportunities for such research there and in the Caribbean generally on a larger scale.

Epidemiological Research Unit, Jamaica

Decolonization in 1962.

Continued support.

British changes minimal – either epidemiological or institutionally

Unchanging discursive logic and conceptualizations.

ERU valued.

Jamaica - Pilot

Studies, 1958- ERU est.

1962

Jamaica - Pilot

Studies, 1958- ERU est.

1962

Great Britain- CMRC

ends 1962- TMRB begins 1962

Great Britain- CMRC

ends 1962- TMRB begins 1962

GM Bull, TMRB Memo, 1966

‘[though] the Epidemiological Research Unit has…been affected by the changing economy of the region…in this case, there remain many opportunities for continued and useful work. These lie primarily in a comparison of African, Indian, and other populations with the same stock living under less favourable conditions, in other tropical areas, and in studying the reasons for interesting difference in disease incidence in the Caribbean.’

TMRB Diabetes Funding

Poon-King et.al. study in Trinidad, 1968. Compared ‘racial’ groups in Trinidad and South Africa.

Other research in Lawrence Tavern, Jamaica – in depth biochemical studies.

De facto monopoly of health-care services. Trinidad –

Poon King et.al. 1968

Trinidad – Poon King et.al. 1968

Structure

• Introduction• Historical Context:– MRC– Colonial Development– Chronic Conditions and Spread of Research Interests

• Case Study – ERU and Diabetes

Conclusion – Postcolonial History of Medicine

Postcolonial Medicine: Conclusions

• May be inaccurate to extend recent findings to all biomedical engagements.

• Including the post-metropole – unmistakeable material and conceptual legacy.

• Restores colonial/post-colonial enterprise to centre of British history.

Trinidad – Poon King et.al. 1968

Study

Trinidad – Poon King et.al. 1968

Study

Jamaica – TMRU, est.

1956- ERU est.

1962

Jamaica – TMRU, est.

1956- ERU est.

1962

Great Britain – MRC est. 1913

- CMRC 1945-1962-TMRB est. 1962

Great Britain – MRC est. 1913

- CMRC 1945-1962-TMRB est. 1962

Cardiff – ERU, Wales,

1960

Cardiff – ERU, Wales,

1960FIN